Welfare reform on the Web (September 2006): National Health Service - primary and community care

Bridging the information gap in primary care

A. Bowron

Community Practitioner, vol.79, 2006, p.242

Results of a survey by Developing Patient Partnerships show that 80% of primary care professionals agree that patients should be given more information about healthy lifestyle choices. Practice nurses are fundamental to improving public healthcare literacy.

Commissioning and managing palliative day care

M. Payne

British Journal of Health Care Management, vol.12, 2006, p.240-244

Although research reviews raise questions about its success in achieving good outcomes for patients, palliative care is popular, mainly because of the social, psychological and spiritual support it offers. This article dissects the detail of research and practice reports to identify ways of setting clear service objectives so that evaluation of palliative care can be more effective in the future.

Community foundation trusts: market forces or forced markets?

J. Trueland

Health Service Journal, vol.116, Aug.24th 2006, p.12-13

The Department of Health is actively considering the creation of community foundation trusts, which would provide the community services currently delivered by primary care trusts, in competition with other entrants to the market. This would free the primary care trusts to focus on service commissioning. This article presents comment from a range of experts in the field.

Development of an information source for patients and the public about general practice services: an action research study

M. Marshall and others

Health Expectations, vol.9, 2006, p.265-274

This article reports on an action research project that engaged members of the public, general practice staff and NHS managers from England and Wales in discussion about the development of information about GP surgeries. The research showed that the public generally did not like league tables comparing the performance of practices and were unlikely to want comparative information to help them choose between practices. Rather, they wanted to know how general practices fitted into the health service as a whole and whether their practice was committed to improvement. They also wanted information about their practice staff, some of which staff were reluctant to provide.

Journal of Health Services Research and Policy, vol.11, 2006, p.150-154

In the English NHS, primary care trusts (PCTs) are responsible for commissioning primary care, hospital care and community and mental health services for their populations. Faced with resource constraints, they may ration access to some treatments such as cosmetic surgery or reversal of sterilisation. However, restriction of services leaves them vulnerable to legal challenge. This paper aims to describe priority setting by a sample of PCTs in Yorkshire and North Lincolnshire, and to compare the descriptive findings with an internationally recognised ethical framework for priority setting “accountability for reasonableness” (AFR). The PCTs varied as regards the stage of policy development they had reached. Rationing by exclusion was the most common approach to prioritisation, but in general PCTs failed to make the rationale for their decisions explicit and accessible. The importance of an appeals process was recognised by the majority of PCTs.

Feel the heat

D. Carlisle

Health Service Journal, vol.116, Aug.24th 2006, p.20-22

Reports reactions of primary care trust chief executives and directors to the fitness for purpose reviews which their organisations are currently undergoing. These are being carried out by management consultants at vast public expense as part of the changes introduced by Commissioning a Patient-Led NHS and are designed to ensure that PCTs are up to the tasks expected of them. Both individual officers and organisations are subject to review using tools developed by consultants McKinsey.

Promoting the health of looked after children in Scotland

A. Simpson

Community Practitioner, vol.79, 2006, p.217-220

This paper aims to raise awareness of the complex heath needs of looked after children and examines factors contributing to their poor health outcomes. It also explores the emerging role of specialist nurses in Scotland in leading and facilitating a multidisciplinary service to identify and address the health needs of this vulnerable population.

Refer to sender

D. Carlisle

Health Service Journal, vol.116, Aug. 10th 2006, p.20-22

In Kingston Primary Care trust all but one of 29 GP practices have voluntarily signed up to a clinical assessment service in which every referral is scrutinised. Referrals arrive electronically via the “choose and book” system. These are reviewed within 24 hours of receipt and inappropriate referrals are returned to the GP with advice for reconsideration.

Rocky patch

N. Golding

Health Service Journal, vol.116, Aug.17th 2006, p.21-22

As primary care trusts (PCTs) come under intense financial pressure, services are cut and costs transferred to social services departments. Councils are being asked to fund cases that would have previously been an NHS responsibility and have seen health partners pull out of joint projects. The best solution to the problem is more and better forward planning and investment in preventative services rather than recriminations. New PCT boundaries which are co-terminous with those of local authorities should help.

What are the key attributes of primary care for patients? Building a conceptual “map” of patient preferences

S. Cheraghi-Sohi and others

Health Expectations, vol.9, 2006, p.275-284

This research examined the international literature about patients’ preferences and developed a conceptual “map” to indicate the aspects of primary care services that matter to people and the ways in which these aspects relate to each other. The major aspects identified were: access; technical care; interpersonal care; patient-centredness; continuity; outcomes; and hotel aspects.